Country- and individual-level determinants of probable problematic gambling in adolescence: A multi-level cross-national comparison

Aims: To estimate the role of family and socio-economic indicators of welfare state in accounting for probable problem gambling during adolescence in a representative sample of students living in nine European countries. Design: Data from the 2011 European School Survey Project on Alcohol and Other Drugs (ESPAD) Study were used for cross-sectional analyses of adolescent probable problem gambling. Setting: Representative surveys in nine European countries. Participants: A total of 31236 16-year-old students. Measurements: Respondents' probable problem gambling, socio-demographic characteristics and parenting (regulation, monitoring and caring) were measured individually. Indicators of wealth (gross domestic product per capita, GDP), expenditure on public health (% GDP) and benefit in kind for families/children (% GDP) were obtained from national public databases. Findings: Students who perceived more parental caring [odds ratio (OR)=0.92, 95% confidence interval (CI)=0.85-0.98] and monitoring (OR=0.57, 95% CI=0.53-0.62) reported less involvement in probable problem gambling. Moreover, students who perceived stronger parental regulation (OR=1.16, 95% CI=1.09-1.23) were more likely to be possible problematic gamblers. At the country level, expenditure on public health was associated negatively with probable problem gambling (OR=0.87, 95% CI=0.78-0.97), whereas GDP per capita (OR=1, 95% CI=1.00-1.00) and the benefits in kind for families/children (OR=1.16, 95% CI=0.89-1.51) showed no association with probable problem gambling. Conclusions: Family characteristics and expenditure on public health may play a key role in explaining probable problem gambling among adolescents in Europe.